[back] Vaccination
and pregnancy
Flu vaccine
racketHello Everyone,
I put the following information together to help all pregnant women know the
Truth about the Flu Shot for pregnancy.
Ahe pdf will also be posted on
www.pandemicfluonline.com and
www.drtenpenny.com tonight so you can print this for family, friends and
patients.
Best regards,
Dr Sherri Tenpenny
www.DrTenpenny.com
____________________________________________________________________________
The Truth about Flu Shots in Pregnancy
Ø Recommendations for vaccinating
pregnant women are new:
· 2004: The
Advisory Committee on Immunization Practice (ACIP) of the CDC began recommending
vaccination in all pregnant women regardless of trimester. By vaccinating
everyone, researchers estimated that an average of 1 or 2 hospitalizations could
be prevented for every 1,000 pregnant women vaccinated.
o REF: MMWR: May 28, 2004 /
53(RR06);1-40.
· 2009: There is
insufficient evidence to recommend routine flu shots as the standard of practice
for healthy women beginning in early pregnancy.
o REF: Skowronski DM, De
Serres G. Is routine influenza immunization warranted in early pregnancy?
Vaccine. Jul 30;27(35):4754-70. 2009.
Ø Pregnant woman are not
frequently hospitalized for flu:
· 1998:
Hospitalization ranged from 3.1 per 10,000 women-months in the first trimester
to 10.5 per 10,000 in the third trimester.
o REF: Neuzil KM, et al.
Impact of influenza on acute cardiopulmonary hospitalizations in pregnant
women. Am J Epidemiol 1998;148:1094-1102.
· 2004: Women in the
third trimester were hospitalized at a rate (250/100,000 pregnant women), a rate
comparable to non-pregnant women who had high-risk medical conditions.
Consider that malpractice liability may play a role in the decision to admit
third trimester women to the hospital.
o REF: MMWR: May 28,
2004 / 53(RR06);1-40.
· 2009: The numbers of
pregnant women hospitalized with pandemic H1N1 infection are small.
Pregnant cases represented 34 of 5,469 H1N1 cases diagnosed during a four month
study.
o REF: Jamieson DJ, et al.
H1N1 2009 influenza virus infection during pregnancy in the USA. Lancet. Aug
8;374(9688):451-8. 2009.
Ø Vaccinating pregnant women has
not reduced hospitalizations.
· 1997-2002: A
study of 49,585 pregnant women there was no statistically significant difference
in rates of illness among vaccinated vs. unvaccinated women (4.5/10,000
vs.4.4/10,000). There were only two admissions per season for pneumonia.
o REF: Black SB, et al.
Effectiveness of the influenza vaccine during pregnancy in preventing
hospitalizations and outpatient visits for respiratory illness in pregnant women
and their infants. Am J Perinatol 21:333-339. 2004.
Ø Pregnant women are
generally as healthy as non-pregnant women.
· 1997-2002: A
study of 49,585 pregnant women, only 4.7% had outpatient visits for
influenza-like illness.
o REF: Black SB, et al.
Effectiveness of the influenza vaccine during pregnancy in preventing
hospitalizations and outpatient visits for respiratory illness in pregnant women
and their infants. Am J Perinatol 21:333-339. 2004.
· 2009: Symptoms of
H1N1 influenza infection are similar in both pregnant and non-pregnant general
population except some pregnant women have more shortness of breath.
o REF: Jamieson DJ, et al.
H1N1 2009 influenza virus infection during pregnancy in the USA. Lancet. Aug
8;374(9688):451-8. 2009.
Ø Careful examination of the
numbers used to mass vaccinate pregnant women reveals:
· H1N1 occurs
infrequently in pregnant women: 34 cases among an estimated 3,392,000 pregnant
women in the U.S.
· Among the 5,469 confirmed
cases in the study, 0.62% were in pregnant women (34/5,469)
· Claims that hospital
admissions among pregnant women are much higher than in the general population
are based on the use of numbers that accentuate the effect (11/34 vs.
229/5,469).
· The admission rate for
pregnant women was 0.32 per 100, 000 and the estimated admission rate in the
general population was 0.076 per 100 000. Hence the statement, “Pregnant women
were more than four times more likely to be admitted than was the general
population.”
o REF: Jamieson DJ, et al.
H1N1 2009 influenza virus infection during pregnancy in the USA. Lancet. Aug
8;374(9688):451-8. 2009.
Ø Both seasonal flu shots and 2009
H1N1 flu shots are labeled “Pregnancy Category C” drugs, meaning:
· Animal reproduction studies have not been conducted.
· It is not known whether influenza vaccines can cause harm to the fetus.
· It is not know whether influenza vaccines can affect reproduction
capacity.
· It is not known whether influenza viruses from vaccines are excreted
in human milk.
o REF: From a review of all manufacturer package inserts
Ø Are anti-viral drugs safe to take while
pregnant?
· Both Tamiflu (oseltamivir)
and Relenza (zanamivir) are classified as “Pregnancy Category C” drugs, meaning,
there is insufficient information to assess potential risks to the fetus.
· In lactating rats, Tamiflu
was excreted in the milk. It is not known whether Tamiflu is excreted in human
milk.
o REF: From the package
inserts